Physician Compare National (NPI:1427043967)

HEALTHCARE PROVIDER: MARK MENEFEE METTAUER M.D.

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1427043967
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	3779565106
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20160106000425
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	METTAUER
	Individual professional last name
Provider First Name	MARK
	Individual professional first name
Provider Gender	M
	The provider's gender if the provider is a person.
Provider Credential Text	MD
	The abbreviations for professional degrees or credentials used or held by the provider, if the provider is an individual. Examples are MD, DDS, CSW, CNA, AA, NP, RNA, or PSY. These credential designations will not be verified by NPS.

Medical School Information
Medical School Name	TEXAS A & M UNIVERSITY SYSTEM, HSC, COLLEGE OF MEDICINE
	Individual professional's medical school
Graduation Year	1997
	Individual professional's medical school graduation year
Primary Specialty	THORACIC SURGERY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	17450 ST LUKES WAY
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 290
	Group Practice or individual's line 2 address
City	THE WOODLANDS
	Group Practice or individual's city
State	TX
	Group Practice or individual's state
Zip Code	773848045
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	450862
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	ST LUKE'S THE WOODLANDS HOSPITAL
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	450670
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	TOMBALL REGIONAL MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 2
Hospital Affiliation CCN 3	450638
	Medicare CCN of hospital where individual professional provides service 3
Hospital Affiliation LBN 3	HOUSTON NORTHWEST MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 3
Professional Accepts Medicare Assignment	Y